Have you watched any movies from the early 1990′s recently? At that time, cell phones were the size of bricks and usually only wealthier people had them.
Fast forward a bit. Cell phones grew smaller and then smarter. Then cell phones weren’t fast enough for our culture – it was email and text messaging. Now? I am told “Texting is so yesterday – people are communicating in 140 characters via Twitter.” There is instant messaging and some are even saying that is too slow.
Think about it – we are communicating more and more via text. How many times do you dash off an email rather than making a call or leaving a voice mail?
What does this mean to private practitioners?
If you are building or marketing a counseling private practice now, you’ve probably already had requests for phone sessions.
But I believe that our “nano-second” culture will sooner or later invite you to deliver services in a way that is appealing to this need for instant connection and connection online.
Your clients or prospects will ask if you can do therapy over the computer. This could be email, social networking, instant messaging chat sessions, online forums and other interesting ways that stretch my thinking such as avatar based “Second Life.”
Will online therapy via text be a service you are interesting in offering?
I think there are many questions that first need to be pondered. The answers may be as unique as each individual practitioner.
Can the same level of therapeutic relationship be created using text-based communication methods?
Taking away the face-to-face interaction will not be appealing to many practitioners. Visual and non-verbal cues can be as important as anything actually said in session. Text might be misinterpreted or impact the client significantly – without the therapist or coach realizing it.
At the same time, the written word is so powerful that it might accelerate progress. It might be easy to ignore a statement from the clinician in a session – but harder to do so online. Clients who need anchoring could read and re-read emails or texts to help them remain grounded. And as more and more people use text as a way of relating, people may actually feel more comfortable with the therapeutic relationship in a cyber-space environment as compared to face-to-face.
Will the fact that it takes a few moments to interact via typing be a benefit or a hinderance to the process?
I could see that in some cases it invites the client to focus on what they want to say. It might take time to develop a rhythm and a process that is comfortable. Online therapy via text might not be a good choice for those who are slow typists or who are uncomfortable with short sentences or misspellings.
Are there legal and ethical considerations?
I do believe that technology is ahead of our laws. Our professional associations are trying to keep up with ‘best practices’ guidelines but with technology moving as fast as it is, that is probably an impossible task.
The issues, opportunities and questions are quite intriguing. And ones that DeeAnna Merz Nagel thinks about a lot. She has (literally) written the book on Online Therapy – which will be out in a few months.
DeeAnna has agreed to speak more about Online Therapy at our International Therapist Leadership Institute Practice Building Virtual Conference – October 13-17, 2009.
That is right, this coming October, we will have a full 5 day conference held over the phone and internet – totally devoted to helping you market your counseling private practice – or your coaching private practice.
My team and I are very excited about this and are in the process of finalizing our speakers and topics. You may be surprised who is already on our faculty! We look forward to sharing more with you soon.
If you’d like to be kept informed of the event – learning about the speakers, topics, and early bird pricing, then let us know and we will keep you updated on the progress and the details. Just visit (xx) and let us know you’d like to be “in the know.”
Online therapy won’t appeal to everyone – clients or clinicians. But it is an interesting option and I expect it will be one that the culture will no-doubt ask us to respond to shortly.
What do you think? I’d love to know. Please share your thoughts below.
Will you offer Online Therapy?
Have you watched any movies from the early 1990′s recently? At that time, cell phones were the size of bricks and usually only wealthier people had them.
Fast forward a bit. Cell phones grew smaller and then smarter. Then cell phones weren’t fast enough for our culture – it was email and text messaging. Now? I am told “Texting is so yesterday – people are communicating in 140 characters via Twitter.” There is instant messaging and some are even saying that is too slow.
Think about it – we are communicating more and more via text. How many times do you dash off an email rather than making a call or leaving a voice mail?
What does this mean to private practitioners?
If you are building or marketing a counseling private practice now, you’ve probably already had requests for phone sessions.
But I believe that our “nanosecond” culture will sooner or later invite you to deliver services in a way that is appealing to this need for instant connection and connection online.
Your clients or prospects will ask if you can do therapy over the computer. This could be email, social networking, instant messaging chat sessions, online forums and other interesting ways that stretch my thinking such as avatar based “Second Life.”
Will online therapy via text be a service you are interesting in offering?
I think there are many questions that first need to be pondered. The answers may be as unique as each individual practitioner.
Can the same level of therapeutic relationship be created using text-based communication methods?
Taking away the face-to-face interaction will not be appealing to many practitioners. Visual and non-verbal cues can be as important as anything actually said in session. Text might be misinterpreted or impact the client significantly – without the therapist or coach realizing it.
At the same time, the written word is so powerful that it might accelerate progress. It might be easy to ignore a statement from the clinician in a session – but harder to do so online. Clients who need anchoring could read and re-read emails or texts to help them remain grounded. And as more and more people use text as a way of relating, people may actually feel more comfortable with the therapeutic relationship in a cyber-space environment as compared to face-to-face.
Will the fact that it takes a few moments to interact via typing be a benefit or a hinderance to the process?
I could see that in some cases it invites the client to focus on what they want to say. It might take time to develop a rhythm and a process that is comfortable. Online therapy via text might not be a good choice for those who are slow typists or who are uncomfortable with short sentences or misspellings.
Are there legal and ethical considerations?
I do believe that technology is ahead of our laws. Our professional associations are trying to keep up with ‘best practices’ guidelines but with technology moving as fast as it is, that is probably an impossible task.
The issues, opportunities and questions are quite intriguing. And ones that DeeAnna Merz Nagel thinks about a lot. She has (literally) written the book on Online Therapy – which will be out in a few months.
DeeAnna has agreed to speak more about Online Therapy at our International Therapist Leadership Institute Practice Building Virtual Conference – October 13-17, 2009.
October 13-17, 2009
That is right, this coming October, we will have a full 5 day conference held over the phone and internet – totally devoted to helping you market your counseling private practice – or your coaching private practice.
My team and I are very excited about this and are in the process of finalizing our speakers and topics. You may be surprised who is already on our faculty! We look forward to sharing more with you soon.
If you’d like to be kept informed of the event – learning about the speakers, topics, and early bird pricing, then let us know and we will keep you updated on the progress and the details. Just click here and let us know you’d like to be “in the know.”
Online therapy won’t appeal to everyone – clients or clinicians. But it is an interesting option and I expect it will be one that the culture will no-doubt ask us to respond to shortly.
What do you think? I’d love to know. Please share your thoughts below.
Tagged as:
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build therapy practice,
Cell Phones,
Clinician,
Communication Methods,
Email,
Instant Messaging,
Interaction,
market a social work practice,
marketing a counseling private practice,
Non Verbal Cues,
Phone Sessions,
Private Practice,
private practitioners,
Prospects,
Second Life,
Session Text,
social networking,
Text Messaging,
Therapeutic Relationship,
therapist business,
Time Cell,
Twitter,
virtual conference,
Voice Mail
{ 11 comments… read them below or add one }
I would also be interested in hearing more about how Skype is used in counseling.
I’m really interested in hearing from others about the use of Skype, too.
I have been working providing chat & phone counseling for the last year and I enjoy it a lot. What I find the most difficult is that in my experience most people looking for online counseling usually do not present the commitment of coming back every week and mostly want a quick solution or answer in one session. In regards to the format I find it very convenient and yes it requires a different way of reading the client and picking up clues but I really like it. It might be a matter of personal preference. It might be a different way of doing counseling and not the traditional way we know just in a different format. There are different technological ways that provide security encryption but skype is not one of those.
I would be interested to know if somebody has experience having regular counseling sessions with one client online and how did you get that client? Did he/she signed up for weekly sessions or you offer that?
Thanks to everybody.
Isabel
I too am wondering about integrating Skype for voice and video counselling. Does anyone else have experience with this that you could share with us?
After having face-to-face sessions with my clients, I write up their session notes in letter format and email it to them (if they provide informed consent). My clients report that they review the email during the week and take the time to reflect upon our conversations. They also say that they appreciate the encouragement in my written comments and are therefore more motivated to do their homework. As I am writing session notes anyway, this seems like an easy way to provide support using the internet.
I wonder about using Skype for voice and video counselling? My question is how secure is the connection, and therefore, how confidential? Email is not secure, and I remind clients of this as part of the informed consent process.
I’ve been doing telephone counseling with long distance individuals and couples for many years. We’ve shared brief emails, but I don’t think I would be comfortable with texting–I rely a lot on what I hear, how things are said, in order to intuit more of what they mean by the words.
I occasionally use e-mail and have found it a great tool to fill times when the client is out of town etc., but have never used text messaging…probably because I don’t use it, period :>)
RE: avatars
I have started to check into Second Life as a possible delivery tool for workshops. They only use Second Life currency so I’m unsure about the money stream.
I have begun investigating on-line methods of therapy. I used texting once with a teen client, he started it, it was in a crisis situation. The client was able to express well. However, when he disconnected I couldn’t do anything to reconnect with him. I did contact the parent to follow up, check in, support, get help etc. That’s my biggest concern with on-line is the loss of connection. At least in the office, they can’t run too far.
Regarding online therapy/texting therapy. I have real concerns about this as email/texting has caused HUGE problems with a number of couples in my practice. The short, often curt responses which are devoid of voice tone and nuance have created an escalating pattern of conflict and misuderstanding. I have asked couples to limit their texting or emailing to each other to mundane subjects like “can you please pick up bread on the way home?” The instantness of email/text often leads to communication when the person is flooded and has led to one partner blasting another. It seems to me this is another way for people to disconnect from each other and not risk building a safe attachment. It seems to work against all of the goals of therapy.
Sandy Jardine, M.S. LPC
Thanks for the mention Casey! Looking forward to the Practice Building Virtual Conference in October! Many practitioners across the globe are wondering how to incorporate online therapy into their existing practices so I will be glad to discuss some basic”Get Started” issues along with ethical considerations for doing the work.
DeeAnna